Walker Annika L, Witteveen Anke B, Otten René H J, Verhoeven Corine J, Henrichs Jens, de Jonge Ank
Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands.
Medical Library, Vrije Universiteit Amsterdam, The Netherlands.
BJPsych Open. 2022 May 6;8(3):e89. doi: 10.1192/bjo.2022.60.
Antepartum depressive symptoms (ADS) are highly prevalent and may affect the mother and child. Cognitive-behavioural therapy and interpersonal therapy are effective psychological interventions for depression. However, low adherence and high attrition rates in studies of prevention and treatment of antepartum depression suggest that these approaches might not be entirely suitable for women with mild/moderate ADS. Considering the protective association between resilience and ADS, women with ADS might benefit more from interventions focusing on promotion of mental well-being and resilience.
We aimed to provide an overview of studies evaluating the effectiveness of antepartum resilience-enhancing interventions targeting the improvement of ante- and postpartum depressive symptoms. We also investigated whether these interventions improve resilience and resilience factors in the peripartum period.
We conducted a systematic review, using PRISMA guidelines. Studies were eligible for inclusion when they utilised a randomised controlled trial or quasi-experimental design, studied pregnant women with ADS, and implemented psychological interventions that (a) aimed to reduce maternal ADS and/or prevent peripartum major depression, and (b) addressed one or more psychological resilience factors.
Five of the six included cognitive-behavioural therapy interventions and all four mindfulness-based interventions were effective in reducing peripartum depressive symptoms and/or the incidence of depression. However, the methodological quality of most of the included studies was low to moderate. Only three studies assessed change in resilience factors.
Resilience-enhancing interventions might be beneficial for mental well-being of pregnant women with ADS, although more rigorously designed intervention studies are needed.
产前抑郁症状（ADS）非常普遍，可能会影响母亲和孩子。认知行为疗法和人际疗法是治疗抑郁症有效的心理干预措施。然而，产前抑郁症防治研究中的低依从性和高损耗率表明，这些方法可能并不完全适用于患有轻度/中度ADS的女性。考虑到心理韧性与ADS之间的保护关联，患有ADS的女性可能会从侧重于促进心理健康和心理韧性的干预措施中获益更多。
我们旨在综述评估旨在改善产前和产后抑郁症状的增强产前心理韧性干预措施有效性的研究。我们还调查了这些干预措施是否能在围产期改善心理韧性及其相关因素。
我们按照PRISMA指南进行了一项系统综述。当研究采用随机对照试验或准实验设计、研究患有ADS的孕妇，并实施旨在（a）减轻母亲ADS和/或预防围产期重度抑郁症，以及（b）涉及一个或多个心理韧性因素的心理干预措施时，这些研究才有资格纳入。
六项纳入研究中的五项认知行为疗法干预措施以及所有四项基于正念的干预措施在减轻围产期抑郁症状和/或抑郁症发病率方面均有效。然而，大多数纳入研究的方法学质量为低到中等。只有三项研究评估了心理韧性因素的变化。
增强心理韧性的干预措施可能对患有ADS的孕妇的心理健康有益，尽管还需要设计更严谨的干预研究。
